Guidelines for psychosocial support for uniformed services

Impact, December 2011

In the Netherlands, in 2010 the Multidisciplinary Guidelines for the psychosocial support of uniformed services organizations (USOs) were developed. These guidelines are accepted as a national standard for psychosocial support for police, firebrigade, ambulance services, the Ministry of Defence and coast guard.

Members of USOs are frequently exposed to potentially shocking events. Although USO members are well prepared for their work, the USO has an obligation in providing the best possible support for their employees when needed. The goal of the guidelines is to guarantee optimal psychosocial support and care after experiencing disasters and shocking events, so that stress-related health problems among members of the emergency services are prevented.

The guidelines are evidence-based, i.e. they are based on the results of the latest scientific studies, knowledge from experience (best practices) and other considerations. Consensus was reached that the promotion of the existing means of recovery of the USO member, and the facilitation of these means by peer support structures, are the key to a successful psychosocial support system. The peer support system has an important role in recognising those affected with psychological and/or serious clinical symptoms that require diagnosis and/or treatment. Diagnosis and treatment should be exercised by mental health professionals. Therefore, they must be readily available, but should only be deployed when necessary. Three phases in the psychosocial support for USO members are discerned: preparation (selection, information and training), peer support and monitoring, and, if necessary, referral for professional care. The guidelines provide recommendations for the USO for each of these phases.

During the European project EUTOPA-IP European and international experts discussed these national guidelines as a basis for further (European and international) implementation and use. The discussion resulted in a number of interesting conclusions. There is general consensus about the core assumptions and recommendations of the guidelines. First of all, the focus on the uniformed worker and his/her own resilience in coping with potentially traumatic events is seen as a productive starting point for the development of guidelines. Second, consensus exists about the tasks ascribed to peer support in the guidelines: peer support should always be directed toward (practical) assistance, stimulating healthy recovery and if necessary referral to professional care. Third, employers have an important responsibility in preventing and resolving psychosocial trauma.

The guidelines also formed a basis for discussion about their applicability in different national contexts. Two topics were of particular interest. First the scope of the peer support tasks: some experts argue that peer support should also have a therapeutic component, whereas others believe therapy should only be provided by professionals. And second the moment of involvement of professional care: should it be shortly after the potentially traumatic event, or should they only get involved once they have been alerted by for example peer supporters?

The purpose of the discussion was to add "European Value" to the guidelines. This has most definitely proven to be the case. Resulting in the overall conclusion that the guidelines are a solid foundation for the development of country specific guidelines and are generally recognized as (a basis for) European Guidelines.